Sun exposure and vitamin D are independent risk factors for CNS demyelination

Lucas, R.M., Ponsonby, A.L., Dear, K., Valery, P.C., Pender, M.P., Taylor, B.V., Kilpatrick, T.J., Dwyer, T., Coulthard, A., Chapman, C., van der Mei, I., Williams, D. and McMichael, A.J. (2011) Sun exposure and vitamin D are independent risk factors for CNS demyelination. Neurology, 76 6: 540-548. doi:10.1212/WNL.0b013e31820af93d

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Author Lucas, R.M.
Ponsonby, A.L.
Dear, K.
Valery, P.C.
Pender, M.P.
Taylor, B.V.
Kilpatrick, T.J.
Dwyer, T.
Coulthard, A.
Chapman, C.
van der Mei, I.
Williams, D.
McMichael, A.J.
Title Sun exposure and vitamin D are independent risk factors for CNS demyelination
Journal name Neurology   Check publisher's open access policy
ISSN 0028-3878
Publication date 2011-02-01
Sub-type Article (original research)
DOI 10.1212/WNL.0b013e31820af93d
Open Access Status DOI
Volume 76
Issue 6
Start page 540
End page 548
Total pages 9
Place of publication Philadelphia, PA, U.S.A.
Publisher Lippincott Williams & Wilkins
Language eng
Subject 2728 Clinical Neurology
Abstract Objectives: To examine whether past and recent sun exposure and vitamin D status (serum 25-hydroxyvitamin D [25(OH)D] levels) are associated with risk of first demyelinating events (FDEs) and to evaluate the contribution of these factors to the latitudinal gradient in FDE incidence in Australia. Methods: This was a multicenter incident case-control study. Cases (n = 216) were aged 18-59 years with a FDE and resident within one of 4 Australian centers (from latitudes 27°S to 43°S), from November 1, 2003, to December 31, 2006. Controls (n = 395) were matched to cases on age, sex, and study region, without CNS demyelination. Exposures measured included self-reported sun exposure by life stage, objective measures of skin phenotype and actinic damage, and vitamin D status. Results: Higher levels of past, recent, and accumulated leisure-time sun exposure were each associated with reduced risk of FDE, e.g., accumulated leisure-time sun exposure (age 6 years to current), adjusted odds ratio (AOR) = 0.70 (95% confidence interval [CI] 0.53-0.94) for each ultraviolet (UV) dose increment of 1,000 kJ/m (range 508-6,397 kJ/m). Higher actinic skin damage (AOR = 0.39 [95% CI 0.17-0.92], highest grade vs the lowest) and higher serum vitamin D status (AOR = 0.93 [95% CI 0.86-1.00] per 10 nmol/L increase in 25(OH)D) were independently associated with decreased FDE risk. Differences in leisure-time sun exposure, serum 25(OH)D level, and skin type additively accounted for a 32.4% increase in FDE incidence from the low to high latitude regions. Conclusions: Sun exposure and vitamin D status may have independent roles in the risk of CNS demyelination. Both will need to be evaluated in clinical trials for multiple sclerosis prevention. Copyright
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Document type: Journal Article
Sub-type: Article (original research)
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Created: Sun, 06 Mar 2011, 10:05:07 EST